title: Antidiabetic effects of duodenojejunal bypass in an experimental model of diabetes induced by a high-fat diet.
abstract: BACKGROUND
  Obese patients with type II diabetes who undergo bariatric surgery revert to normal blood glucose and insulin levels, and develop a dramatic increase in insulin sensitivity. However, the mechanisms involved are unknown. This study characterized pancreatic islet and duodenojejunal enteroendocrine cells in normal mice and those with diabetes induced by a high-fat diet (HFD) following duodenojejunal bypass (DJB).
  
  
  METHODS
  C57BL/6J mice, fed for 8 weeks either a normal diet (n = 10) or a HFD (n = 10) resulting in a hyperglycaemic state, underwent DJB (connection of the distal end of the jejunum to the distal stomach and direction of biliopancreatic secretions to the distal jejunum). Metabolic and immunohistological analyses were carried out on the pancreas and gastrointestinal tract.
  
  
  RESULTS
  A significant decrease in fasting blood glucose was observed in normal-DJB and HFD-DJB mice 1 week after the operation, with improved glucose tolerance at 4 weeks. There were no changes in pancreatic β-cell mass, but an increase in the ratio of α-cell to β-cell mass was observed in the DJB groups. Furthermore, the number of cells expressing Pdx-1, glucagon-like peptide 1, pancreatic polypeptide and synaptophysin was increased in the bypassed duodenum and/or gastrojejunum of the DJB groups.
  
  
  CONCLUSIONS
  Both normal and obese diabetic mice that underwent DJB displayed improved glucose tolerance and a reduction in fasting blood glucose, which mimicked findings in obese diabetic patients following bariatric surgery. The present data suggest that an increase in specific enteroendocrine cell populations may play a critical role in normalizing glucose homeostasis.
authors.affiliation: Children's Health Research Institute, University of Western Ontario, London, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Woods
authors.forename: Z
authors.initials: Z
authors.lastname: Lan
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: M B
authors.initials: MB
authors.lastname: Wheeler
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: R
authors.initials: R
authors.lastname: Wang
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D002766:Cholecystokinin / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000473:pathology / Q000601:surgery*; D004032:Diet / Q000009:adverse effects; D004041:Dietary Fats / Q000008:administration & dosage*; D004386:Duodenum / Q000601:surgery*; D004435:Eating; D005455:Fluorescent Antibody Technique; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D018398:Homeodomain Proteins / Q000378:metabolism; D006706:Homeostasis; D007515:Islets of Langerhans / Q000473:pathology; D007583:Jejunum / Q000601:surgery*; D051379:Mice; D008810:Mice, Inbred C57BL; D008820:Mice, Obese; D015534:Trans-Activators / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D004041:Dietary Fats; D018398:Homeodomain Proteins; D015534:Trans-Activators; C084010:pancreatic and duodenal homeobox 1 protein; D052216:Glucagon-Like Peptide 1; D002766:Cholecystokinin